Hypomethylating agents (Hmas) as salvage therapy in relapsed or refractory aml: An italian multicentric retrospective study

Federica Lessi, Marica Laurino, Cristina Papayannidis, Orsola Vitagliano, Francesco Grimaldi, Davide Lazzarotto, Michele Gottardi, Elena Crisà, Marta Riva, Gianluigi Reda, Mario Ermani, Gianpietro Semenzato, Livio Trentin, Felicetto Ferrara

Research output: Contribution to journalArticlepeer-review


Data on the use of azacytidine and decitabine as salvage therapy for acute myeloid leukemia are limited. We retrospectively reviewed clinical records of 100 patients treated with hypomethylating agents (HMA) as salvage therapy in nine Italian institutions. A total of 24% of patients obtained a response to HMA (CR, PR, or CRi), while 26% showed a stable disease (SD); 50% of patients experienced progressive disease. Median OS was 6.5 months. OS in patients with de novo AML was 6.1 months, while OS in patients with secondary AML (sAML) was 12.3 months (p = 0.037). Median OS after HMA in patients with SD as best response to HMA was similar to median OS in patients with response to HMA (10.6 months vs. 13 months). On multivariate analysis, OS difference between patients who obtained a response versus patients who did not was significant (p = 0.0037). OS difference in sAML was significantly better than in de novo AML (p < 0.00001). HMA showed a remarkable efficacy in terms of response rate and OS in a subgroup of patients (sAMLs), historically characterized by a poor outcome. Therefore, 5Azacitidine and decitabine may represent a good clinical option in a selected patient population with relapsed or refractory AML, unsuitable for allo-HSCT.

Original languageEnglish
Article number972
Issue number8
Publication statusPublished - Aug 2021


  • Acute myeloid leukemia
  • Azacytidine
  • Decitabine
  • HMA
  • Refractory
  • Relapsed

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biochemistry, Genetics and Molecular Biology(all)


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